How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,819.70 Median $2,398.83 Typical High $9,772.37 | Facility | None | $1,819.70 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $275.42 | Professional | None | $199.53 | $275.42 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,467.37 | Facility | None | $1,288.25 | $1,548.82 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $602.56 | Professional | None | $269.15 | $407.38 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $331.13 Typical High $575.44 | Facility | None | $251.19 | $331.13 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $1,174.90 | Professional | None | $363.08 | $562.34 | $1,174.90 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $363.08 Median $616.60 Typical High $1,258.93 | Professional | None | $363.08 | $616.60 | $1,258.93 |
United Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
United Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $1,000.00 | Professional | None | $398.11 | $549.54 | $1,000.00 |
Well Sense Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $100.00 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $40.74 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $151.36 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $30.20 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.95 | $27.54 | $27.54 |
Where New Hampshire sits
The same service costs 2.9 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New Hampshire· 20th of 51
$468
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.